Individual
DR. JEFFREY MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4801 S CLIFF AVE STE 208, INDEPENDENCE, MO 64055-6954
(816) 461-3660
(816) 461-4151
Mailing address
2225 NE OVERLAND DR, BLUE SPRINGS, MO 64029-8604
(816) 875-9154
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6845
NV
1223G0001X
General Practice Dentistry
Primary
2016019198
MO
1223G0001X
General Practice Dentistry
61488
KS
Other
Enumeration date
10/25/2016
Last updated
08/20/2019
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